Adiponectin and insulin resistance in gestational diabetes: a comparative cross-sectional study

Background & objective: Gestational diabetes mellitus (GDM) is a common pregnancy related complication and is associated with insulin resistance and adverse perinatal outcomes. Reduced adiponectin, a hormone that regulates glucose and insulin sensitivity, has been implicated in GDM pathogenesis. We evaluated the association between serum adiponectin levels and insulin resistance in parturients with GDM and normoglycemic pregnancies, and to assess its diagnostic potential. Methodology: A cross‐sectional study was conducted on pregnant women (24–36 weeks gestation) classified as GDM or controls per established criteria. Fasting blood samples were analyzed for glucose, insulin, and adiponectin, and insulin resistance was estimated using the HOMA‐IR index. Statistical analyses included correlation, regression, and ROC curve analysis. Results: Compared to controls, GDM patients had significantly higher BMI, fasting glucose, insulin, and HOMA‐IR, but markedly lower adiponectin levels. Adiponectin showed a strong inverse correlation with insulin resistance markers, and ROC analysis confirmed its excellent diagnostic accuracy for GDM. Conclusion: Reduced adiponectin is closely linked to increased insulin resistance in GDM, highlighting its potential as a diagnostic biomarker and therapeutic target. Abbreviations: GDM: Gestational diabetes mellitus, IL-6: interleukin-6, TNF-α: tumor necrosis factor-alpha, OGTT: oral glucose tolerance test. PPAR-α: peroxisome proliferator-activated receptor alpha, AMPK: AMP-activated protein kinase. Keywords: Gestational Diabetes Mellitus; Adiponectin; Insulin Resistance; HOMA-IR; Diagnostic Biomarker; Pregnancy, Citation: Hadi SH, Hassan ASU, Abd Alredha RD. Adiponectin and insulin resistance in gestational diabetes: a comparative cross-sectional study. Adiponectin and insulin resistance in gestational diabetes: a comparative cross-sectional study. Anaesth. pain intensive care 2025;29(3):422-429. DOI: 10.35975/apic.v29i3.2753 Received: February 16, 2025; Revised: February 19, 2025; Accepted: March 24, 2025